<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0121-4004</journal-id>
<journal-title><![CDATA[Vitae]]></journal-title>
<abbrev-journal-title><![CDATA[Vitae]]></abbrev-journal-title>
<issn>0121-4004</issn>
<publisher>
<publisher-name><![CDATA[Facultad de Química Farmacéutica, Universidad de Antioquia]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0121-40042010000300012</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[PRO-APOPTOTIC EFFECTS OF APPLE PROCYANIDINS IN HUMAN COLON CANCER CELLS AND THEIR DERIVED METASTATIC CELLS]]></article-title>
<article-title xml:lang="es"><![CDATA[EFECTO PRO-APOPTÓTICO DE PROCIANIDINAS DE MANZANA EN CÉLULAS HUMANAS DE CÁNCER DE COLON Y SUS CÉLULAS METASTÁSICAS DERIVADAS]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[MALDONADO C]]></surname>
<given-names><![CDATA[María E]]></given-names>
</name>
<xref ref-type="aff" rid="A01"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[RAUL]]></surname>
<given-names><![CDATA[Francis]]></given-names>
</name>
<xref ref-type="aff" rid="A02"/>
</contrib>
</contrib-group>
<aff id="A01">
<institution><![CDATA[,Universidad de Antioquia Escuela de Nutrición y Dietética Grupo de Alimentación y Nutrición Humana]]></institution>
<addr-line><![CDATA[Medellín ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="A02">
<institution><![CDATA[,Université de Strasbourg Faculté de Médecine ]]></institution>
<addr-line><![CDATA[Strasbourg ]]></addr-line>
<country>France</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>09</month>
<year>2010</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>09</month>
<year>2010</year>
</pub-date>
<volume>17</volume>
<numero>3</numero>
<fpage>337</fpage>
<lpage>347</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S0121-40042010000300012&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S0121-40042010000300012&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S0121-40042010000300012&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Apples are a rich source of Procyanidins (Pcy) which are able to inhibit colon carcinogenesis in animal models, but the mechanisms through which this occurs are not well understood.The evidence obtained in our laboratory and by other researchers, which shows that Pcy trigger apoptosis through different mechanisms in human colon adenocarcinoma SW480 cells and their derived-metastatic SW620 cells is reviewed in this paper. In the apoptosis induced by Pcy, the polyamine metabolism is involved, but it is not present in SW480 cells. There is a differential sensitivity of both cells lines to the activation of TRAIL-death receptors. Pcy enhance the sensitivity of SW480 cells to TRAIL by activating the extrinsic apoptotic pathway, and overcome TRAIL-resistance in SW620 cells involving a cross-talk between the extrinsic and intrinsic pathways; and a Pcy-induced ROS production favoring mitochondria disruption. In addition, Pcy activate Fas receptor in SW480 cells, whereas SW620 cells are Fas-resistant despite the up-regulated Fas expression. Surprisingly, activation of the Fas receptor-mediated apoptosis by Pcy is observed in SW620 cells after inactivation of TRAIL-death receptors, suggesting that Fas-resistant phenotype may be associated with alterations in downstream events between TRAIL-death and Fas receptors. These data highlight the potential interest of apple Pcy in colon cancer prevention and therapy (combination therapy).]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Las manzanas son fuente rica en Procianidinas (Pcy), inhiben la carcinogénesis del colon en modelos animales aunque los mecanismos no son bien comprendidos. Esta revisión presenta evidencia sobre los efectos pro-apoptóticos de Pcy por diferentes mecanismos en células humanas de adenocarcinoma de colon SW480 y sus derivadas metastáticas SW620. En la apoptosis inducida por Pcy en células SW620 participa el metabolismo de poliaminas, pero no en células SW480. Existe sensibilidad diferencial de ambas líneas a la activación de los receptores de muerte-TRAIL. Pcy aumenta la sensibilidad de SW480 a TRAIL activando la vía extrínseca, y sobrepasa la resistencia a TRAIL en células SW620 mediante interacción entre las vías extrínseca e intrínseca, y producción de especies reactivas del oxígeno (ROS) con daño mitocondrial. Pcy activan el receptor Fas en células SW480, mientras que las células SW620 son Fas-resistentes a pesar del aumento en la expresión de Fas. La activación de la apoptosis vía Fas por Pcy se observa en células SW620 después de inactivar los receptores de muerte-TRAIL, sugiriendo que el fenotipo Fas-resistente podría estar asociado con alteraciones corriente-abajo entre los receptores TRAIL y Fas. Estos datos resaltan el potencial interés en las Pcy de manzana para la prevención y terapia combinada del cáncer de colon.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[apoptosis]]></kwd>
<kwd lng="en"><![CDATA[colon cancer]]></kwd>
<kwd lng="en"><![CDATA[flavonoids]]></kwd>
<kwd lng="en"><![CDATA[TRAIL]]></kwd>
<kwd lng="en"><![CDATA[Fas]]></kwd>
<kwd lng="es"><![CDATA[apoptosis]]></kwd>
<kwd lng="es"><![CDATA[cáncer de colon]]></kwd>
<kwd lng="es"><![CDATA[flavonoides]]></kwd>
<kwd lng="es"><![CDATA[TRAIL]]></kwd>
<kwd lng="es"><![CDATA[Fas]]></kwd>
</kwd-group>
</article-meta>
</front><body><![CDATA[ <p align="right"><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> <b>REVIEWS </b></font></p>     <p>&nbsp;</p>     <p align="center"><b><font face="Verdana, Arial, Helvetica, sans-serif" size="4"> PRO-APOPTOTIC EFFECTS OF APPLE PROCYANIDINS IN HUMAN COLON CANCER CELLS AND THEIR DERIVED METASTATIC CELLS</font></b></p>     <p>&nbsp;</p>     <p align="center"><b><font face="Verdana, Arial, Helvetica, sans-serif" size="3">EFECTO PRO-APOPT&Oacute;TICO DE PROCIANIDINAS DE   MANZANA EN C&Eacute;LULAS HUMANAS DE C&Aacute;NCER DE COLON Y SUS C&Eacute;LULAS METAST&Aacute;SICAS DERIVADAS</font></b></p>     <p>&nbsp;</p>     <p>&nbsp;</p>     <p><b><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> Mar&iacute;a E. MALDONADO C.<sup>1</sup>, Francis RAUL<sup>2,3</sup></font></b></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2">1 Grupo de Alimentaci&oacute;n y Nutrici&oacute;n Humana. Escuela de Nutrici&oacute;n y Diet&eacute;tica. Universidad de Antioquia. Medell&iacute;n, Colombia. mariaele@quimbaya.udea.edu.co.</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> 2 Universit&eacute; de Strasbourg Unit 4438, Facult&eacute; de M&eacute;decine, 67000 Strasbourg, France.</font></p>     ]]></body>
<body><![CDATA[<p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> 3 Institut de Recherche contre les Cancers de l'Appareil Digestif (IRCAD), 67000 Strasbourg, France. </font></p>     <p>&nbsp;</p> <hr noshade size="1">     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> <b>ABSTRACT</b></font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> Apples are a rich source of Procyanidins (Pcy) which are able to inhibit colon carcinogenesis in animal   models, but the mechanisms through which this occurs are not well understood.The evidence obtained   in our laboratory and by other researchers, which shows that Pcy trigger apoptosis through different  mechanisms in human colon adenocarcinoma SW480 cells and their derived-metastatic SW620 cells   is reviewed in this paper. In the apoptosis induced by Pcy, the polyamine metabolism is involved, but   it is not present in SW480 cells. There is a differential sensitivity of both cells lines to the activation of   TRAIL-death receptors. Pcy enhance the sensitivity of SW480 cells to TRAIL by activating the extrinsic   apoptotic pathway, and overcome TRAIL-resistance in SW620 cells involving a cross-talk between the   extrinsic and intrinsic pathways; and a Pcy-induced ROS production favoring mitochondria disruption.   In addition, Pcy activate Fas receptor in SW480 cells, whereas SW620 cells are Fas-resistant despite the   up-regulated Fas expression. Surprisingly, activation of the Fas receptor-mediated apoptosis by Pcy   is observed in SW620 cells after inactivation of TRAIL-death receptors, suggesting that Fas-resistant   phenotype may be associated with alterations in downstream events between TRAIL-death and Fas   receptors. These data highlight the potential interest of apple Pcy in colon cancer prevention and therapy   (combination therapy).</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> <b>Key words:</b> apoptosis, colon cancer, flavonoids, TRAIL, Fas.</font></p> <hr noshade size="1">     <p><b><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> RESUMEN</font></b><font face="Verdana, Arial, Helvetica, sans-serif" size="2"></font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> Las manzanas son fuente rica en Procianidinas (Pcy), inhiben la carcinog&eacute;nesis del colon en modelos   animales aunque los mecanismos no son bien comprendidos. Esta revisi&oacute;n presenta evidencia sobre los   efectos pro-apopt&oacute;ticos de Pcy por diferentes mecanismos en c&eacute;lulas humanas de adenocarcinoma de   colon SW480 y sus derivadas metast&aacute;ticas SW620. En la apoptosis inducida por Pcy en c&eacute;lulas SW620   participa el metabolismo de poliaminas, pero no en c&eacute;lulas SW480. Existe sensibilidad diferencial de   ambas l&iacute;neas a la activaci&oacute;n de los receptores de muerte-TRAIL. Pcy aumenta la sensibilidad de SW480   a TRAIL activando la v&iacute;a extr&iacute;nseca, y sobrepasa la resistencia a TRAIL en c&eacute;lulas SW620 mediante   interacci&oacute;n entre las v&iacute;as extr&iacute;nseca e intr&iacute;nseca, y producci&oacute;n de especies reactivas del ox&iacute;geno (ROS)   con da&ntilde;o mitocondrial. Pcy activan el receptor Fas en c&eacute;lulas SW480, mientras que las c&eacute;lulas SW620   son Fas-resistentes a pesar del aumento en la expresi&oacute;n de Fas. La activaci&oacute;n de la apoptosis v&iacute;a Fas por   Pcy se observa en c&eacute;lulas SW620 despu&eacute;s de inactivar los receptores de muerte-TRAIL, sugiriendo que   el fenotipo Fas-resistente podr&iacute;a estar asociado con alteraciones corriente-abajo entre los receptores   TRAIL y Fas. Estos datos resaltan el potencial inter&eacute;s en las Pcy de manzana para la prevenci&oacute;n y terapia combinada del c&aacute;ncer de colon.</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> <b>Palabras clave:</b> apoptosis, c&aacute;ncer de colon, flavonoides, TRAIL, Fas.</font></p> <hr noshade size="1">     <p>&nbsp;</p>     <p>&nbsp;</p>     ]]></body>
<body><![CDATA[<p><font face="Verdana, Arial, Helvetica, sans-serif" size="3"> <b>INTRODUCTION</b></font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> Epidemiological studies support an inverse relationship   between regular consumption of fruits,   vegetables, and the risk of CRC (Colorectal Cancer).   Individual non-nutritive polyphenolic compounds   present in fruits, identified as inhibitory agents of   colon carcinogenesis, can be divided into various   classes on the basis of their molecular structure,   with flavonoids being one of the main groups occurring   in human diet. Apples are a rich source of   flavonoids, and its major subclass is flavanols, which   contain monomers (epicatechin and catechin) and   polymeric forms (procyanidins). An <i>in vitro </i>model   of colon carcinogenesis that represents the progression   from a primary tumor (SW480 cells) to   metastatic disease (SW620 cells) was employed, and   it was found that apple procyanidins can directly   or indirectly influence some important targets   involved in apoptosis, such as polyamines metabolism,   TRAIL-death receptor pathway, Fas-receptor   pathway, and mitochondrial integrity. Evidences   presented in this review encourage knowing that a   dietary agent such as apple Pcy presents multipotent   anti-cancer properties and may represent a promising   agent for the chemoprevention of colon cancer   through the induction of apoptosis.</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> <b>General characteristics of procyanidins</b></font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> Procyanidins (Pcy), also known as condensed   tannins, represent the second most abundant class   of plant polyphenols (1). Pcy are widely distributed   in the peel of fruits, legumes, cereal grains, and a   variety of beverages including wine, beer, tea, cocoa,   and cider. Their content is decreased by industrial   food processing methods as fruit peeling, decortications,   juice filtration, maceration, drying or   long-term storaging. For example, natural cloudy   apple juice contains about 2.5-fold more Pcy than   processed clear apple juice (2, 3). They are of interest   in nutrition and medicine due to their potent   antioxidant capacity and possible effects on human   health as they reduce the risk of chronic diseases   such as cardiovascular diseases and cancer.</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> Pcy are di-, tri- and oligomeric condensation   products of flavan-3-ol monomers of (+)-catechin   and (-)-epicatechins; they generally possess 12&#8211;16   phenolic OH-groups and 5-7 aromatic rings/1000   units of relative molecular mass, and they also possess   an average molecular weight of 1000-6000.   Their mean degree of polymerization (DP) in foods   has rarely been determined, however, in cider apples   the DP ranges from 4 to 11 (4).</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> The Pcy content of red wine, chocolate, cranberry   juice and cloudy apple juice (5) and several   varieties of apples (6) has been determined in an   analytical study. On average, apples contain a large   Pcy content per serving (147.1 mg), this corresponds   to 63-77% of apple polyphenols. Moreover, a serving   size of cloudy apple juice contains 48-61% of   Pcy. The Pcy content varied greatly between apple   samples (12.3&#8211;252.4 mg/serving) with the highest   amounts on average observed for the Red Delicious   (207.7 mg/ serving) and Granny Smith (183.3 mg/serving) varieties; and the lowest amounts in the   Golden Delicious (92.5 mg/serving) and McIntosh   (105.0 mg/serving) varieties (5, 6).</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> <b>Apoptosis</b></font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> Apoptosis is a physiological process in which   cells are removed after exposing them to toxic   compounds; it also takes place during development and in degenerative disorders. Apoptosis is a   nontoxic model of cell death which affects single   cells in the midst of living tissues without eliciting   an inflammatory response (7). Apoptosis is considered   to be one of the important targets in a cancer   preventive approach, which provides a physiological   mechanism for the elimination of abnormal cells.   In studies of animal colon cancer, the experimental   enhancement of crypt-cell apoptosis has shown to   suppress the induction of neoplasia by chemical   carcinogens (8, 9).</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> Apoptosis is characterized, at the morphological   level, by cell shrinking, membrane blebbing, nuclear   pyknosis, chromatin condensation, and cellular   fragmentation into so-called apoptotic bodies, rapidly   phagocyted and digested by macrophages (10).   These changes are preceded by biochemical events   such as the redistribution of membrane lipids, the   loss of mitochondrial membrane potential, and the   fragmentation of DNA at internucleosomal sites   (11). There are two main pathways involved in the   induction of apoptosis; a death receptor-pathway   (the extrinsic pathway) and a mitochondrial pathway   (the intrinsic pathway). The apoptotic signal   involves the activation of many proteins that are   part of two major families: the caspases and the   Bcl-2 proteins. Caspases play an important role   in the degradation of cellular organelles, whereas   Bcl-2 proteins participate in the maintenance and   propagation of the signal (7).</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> <b>The polyamines metabolism and apoptosis   triggered by apple Pcy</b></font></p>     ]]></body>
<body><![CDATA[<p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> The putrescine (Put), spermidine (Spd) and   spermine (spm) are aliphatic amines known as polyamines,   which are formed and stored by nearly all eukaryotic   cells. They are required for optimal growth   in cells. The loss of these polyamines results in the   inhibition of cell proliferation and differentiation, and   sometimes even cell death (necrosis and/or apoptosis).   It has been shown that when quiescent cells are   stimulated to growth, the biosynthesis of polyamines   increases before the synthesis of DNA, RNA and   proteins for cell cycle (12, 13). At physiological pH,   the polyamines are nearly completely protonated   which enables them to form ion bonds with a wide   variety of anionic-binding, such as nucleic acids and   proteins, stabilizing their conformations (14).</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> An important function of the polyamines is gene   regulation. The depletion of polyamines affects   the expression of numerous genes, as well as of   protein factors involved in the cell cycle growth   and regulation, and in programmed cell death.   Investigations of the role of the polyamines as   modulators of the binding of transcription factors   and related proteins to relevant DNA sites are   therefore of great interest. Several DNA&#8211;protein   interactions are modulated by polyamines, for   example, spermine improves the binding of   protein to DNA. Another function of polyamines   is their role as precursors of biologically active   compounds such as Hypusine (N-<i>&epsilon;</i>-(4-amino-2-   hydroxybutyl-lysine), the prosthetic group of the   eukaryotic initiation factor eIF-5A, which appears   to be involved in the control of cell proliferation   and apoptosis. Since spermidine is a precursor of   hypusine, the depletion of the spermidine pools   prevents the formation of active eIF5A, therefore,   cells stop growing (12-14).</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> The polyamines metabolism consist of biosynthesis   and catabolic or retroconversion pathways   shown on <a href="#f1">figure 1</a>. The two key enzymes   involved in polyamine biosynthesis are ornithine   decarboxylase (ODC) and S-adenosylmethionine   decarboxylase (AdoMetDC). ODC catalyzes the   formation of putrescine from L-ornithine, and   AdoMetDC decarboxylates <i>S</i>-adenosylmethionine   (AdoMet). The product of this reaction, decarboxylated   <i>S</i>-adenosylmethionine (dcAdoMet), is   the aminopropyl group donor for spermidine and   spermine synthesis. In the catabolic pathway (or   retroconversion pathway) acetylated polyamines are   formed by spermine/spermidine acetyltransferase   (SSAT) and are used as substrates by a flavin-dependent   polyamine oxidase (PAO), which catalyzes   their conversion back to spermidine, and finally to   putrescine (14).</font></p>     <p>&nbsp;</p>     <p align="center"><a name="f1"></a><img src="img/revistas/vitae/v17n3/v17n3a12f1.jpg"></p>     <p>&nbsp;</p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> The polyamine metabolism differs in various   aspects in SW480 and SW620 cells (16, 17). The   polyamine metabolism has been studied as a potential   target of apple Pcy because they are involved   in cell proliferation and in the maintenance of cell   viability. Apple Pcy-induced apoptosis in SW480   and SW620 cells is potentiated by the use of MDL   72527 (MDL), a specific inhibitor of PAO, in the   metastatic SW620 cells (18) but not in SW480 cells.   This difference in sensitivity to MDL in SW480   and SW620 cells is probably not a function of PAO   activity, which presents similar activity in both cell   lines (16). Therefore other aspects may be involved,   such as the intracellular pool of polyamines and   their acetylated forms.</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2">  Pcy-induced apoptosis in SW620 cells is accompanied   by a decreased intracellular pool of   polyamines and a higher accumulation of acetylated   polyamines, respectively indicating a reduction   of polyamine biosynthesis and an enhanced   polyamine catabolism (18). This is correlated to a   previous report by Goss&eacute; <i>et al</i>., 2005 (8), showing   Pcy down-regulated ODC and AdoMet DC activities   in SW620 cells, the two enzymes of polyamine   biosynthesis. These effects of Pcy on polyamines   metabolism are enhanced in presence of MDL   72527, a specific inhibitor of PAO activity. The   depletion of the intracellular pool of polyamines   in presence of Pcy/MDL led to apoptosis, and the   addition of exogenous polyamines to SW620 cell   culture inhibit the potentiation by MDL of Pcytriggered   apoptosis, which confirms the importance   of polyamines (putrescine, spermidine and   spermine) for cell proliferation and maintenance   of cell viability (18).</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> The massive formation of acetylated polyamines   may contribute to cell death due to the depletion of   Acetyl-CoA (19). In addition, there is a discussion   speculating the possibility that the accumulation of   intracellular N-acetylated polyamines affects histone   acetylation by competing with the acetyl-CoA:   spermidine N8-acetyltransferase, an enzyme that   also has histone acetylating properties (20). However,   findings in SW620 cells suggest that in the presence   of Pcy, MDL might favor the hyperacetylation   of the promoters of TRAIL-death receptors, leading   to the up-regulation of DR4/DR5 expression (21,   22); which may be controlled at the transcriptional   level, favored by an inhibition of 50% nuclear Histone   deacetylase (HDAC) activity caused by Pcy/MDL. Under these conditions, the activation of   the extrinsic apoptotic pathway has been induced   through the TRAIL-death receptors, confirmed   by the reduction of Pcy/MDL-induced cell death   after a specific inhibition of DR4/DR5 receptors   (18). The SW620 cell line is normally resistant to   TRAIL-death receptor mediated apoptosis because   they do not express DR4 and DR5 receptors at   the cell surface (23). Thus, the activation by Pcy/MDL of TRAIL-death receptor mediated apoptosis   through the modulation of polyamine metabolism   can be of great interest in chemoprevention, since   this pathway can preferentially activate apoptosis   in cancer cells but not in normal non-cancerous   cells (24). Furthermore, the Pcy/MDL combination   could potentiate the effect of TRAIL exogenous   and/or the TRAIL produced by cells of innate immune   system (25).</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> The apoptotic pathway activated by Pcy only   in SW620 cells is different to the one observed in   presence of MDL (18). Pcy activate the intrinsic   mitochondrial apoptotic pathway through the   alteration of mitochondrial membrane potential,   involving the activation of caspases-9 and -3. These   effects caused by the Pcy-enhanced ROS production   (26) are prevented by MDL. Indeed, MDL   inhibits ROS generated through the activation of   polyamine catabolism caused by Pcy. This increase   of intracellular ROS may be a way to kill cancer   cells by activating the mitochondrial permeability   transition (27, 28).</font></p>     ]]></body>
<body><![CDATA[<p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> Apple Pcy also induce apoptosis in SW480 cells,   although this effect is not enhanced by MDL 72527   as observed in SW620 cells, which suggest that Pcyinduced   apoptosis in SW480 cells is unrelated to the   production of H<sub>2</sub>O<sub>2</sub> by the oxidation of N1-acetyl derivatives   of spermidine and spermine. This reaction   is catalyzed by the PAO when these acetylated polyamines   are excessively formed by the SSAT enzyme   (15). SW480 cells seem to be less sensitive to combined   treatment of Pcy and MDL in comparison to   SW620 cells, despite the similar PAO activity in both   cell lines under basal conditions (16). This difference   on the apoptotic effects observed with Pcy/MDL   in SW480 cells may be related to low polyamine   biosynthetic activity and low intracellular content of   acetylated forms of the polyamines observed in these   cells (25). Indeed, if Pcy down-regulate polyamine   biosynthesis (8, 15), which already is significantly low   under basal conditions in SW480 cells (16, 17); the   levels of non-acetylated forms of polyamines would   probably be lower in these cells.</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> In SW480 cells, Pcy only or combined with   MDL activate an extrinsic apoptotic pathway by   up-regulating expression of TRAIL-death receptors   DR4/DR5. We investigated whether the activation of   TRAIL-death receptor pathway under these conditions   was associated to a reduced activity of HDAC.   Pcy, as well as MDL, used individually do not affect   the enzyme activity; whereas MDL in combination   with Pcy reduced by 20% HDAC activity, which   could favor hyperacetylation of the promoters of   DR4/DR5 receptors. However, no significant difference   is observed in the percentage of SW480 cells   expressing DR4/DR5 receptors after Pcy only or   combined Pcy/MDL treatments, which suggests that   the enhanced expression of TRAIL-death receptors   at the cell surface of SW480 cells might be regulated   at a post-transcriptional level (29). The alteration of   the polyamine metabolism is a factor involved in the   Pcy-induced apoptosis of SW620 metastatic cells, but   not of SW480 colon cancer cells.</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> <b>Activation of TRAIL-death receptor mediated   pathway</b></font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> Tumor necrosis factor a-related apoptosis-inducing   ligand (TRAIL) is a death ligand expressed   in the majority of human tissues. It has been demonstrated   that four Death Receptors (DRs) are specifically   bound to TRAIL: two cell death-inducing   receptors (TRAIL-R1/DR4 and TRAIL-R2/DR5) and two non-cell-death-inducing receptors   (TRAIL-R3/DcR1 and TRAIL-R4/DcR2), (27,   28). Like TRAIL, these receptors are expressed in   a wide variety of tissues. However, it has been reported   that TRAIL demonstrates selective toxicity   to cancer cells, but not to normal cells (30, 31). DR4   and DR5 signal apoptosis through the interaction   with FADD and caspase 8 (30, 32) may activate the   intrinsic mitochondrial cell death pathway (33). In   addition to apoptosis, TRAIL ligation of DR4 and   DR5 can activate NF-kB and p53 (34, 35).</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> Once it was showed that Pcy can induce apoptosis   in SW480 and SW620 cells through the activation of   TRAIL-death receptors DR4/DR5, the mechanism   through which DR4/DR5 could be activated downstream   by Pcy only or in the presence of exogenous   TRAIL was described in both cell lines. Pcy enhance   the sensitivity to the apoptotic effects of TRAIL in   SW480 cells and overcome TRAIL-resistance in   SW620 cells (26). The co-administration of Pcy   and TRAIL enhance apoptotic signaling, leading   to nuclear DNA fragmentation in both cell lines   compared to TRAIL alone (29).</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> In SW480 cells, the increased expression of   DR4/DR5 receptors by Pcy at the cell surface enhanced   the sensitivity to TRAIL. In these cells, the   main apoptotic pathway activated by Pcy only and   combined with TRAIL is the extrinsic pathway,   involving the activation of caspase-8 and caspase-3.   Mitochondrial dysfunctions observed in SW480   cells exposed to Pcy and Pcy/TRAIL is limited and   do not cause the release of cytochrome c into cytosol   and caspase-9 activation, because neither Bid   protein nor Bcl-2/Bax are modified. In contrast, in   the metastatic SW620 cells, Pcy initiate apoptosis   through a crosstalk between the TRAIL-death   receptor pathway and the intrinsic (mitochondrial)   apoptotic pathway through an activation of the   caspase-8, a reduction of full length Bid protein,   and parallel to a progressive increase Bax protein   and mitochondria membrane permeabilization.   Such mitochondrial dysfunction favors the release   of cytochrome c into cytosol, leading to the activation   of caspase-9 and, consequently, caspase-3. In   SW620 cells, these events are associated to ROS   production induced by Pcy which are also enhanced   in the presence of exogenous TRAIL (26).</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> The importance to activate the TRAIL apoptotic   pathway for the treatment of cancer is highlighted   by the recent introduction of TRAIL-receptor   agonistic antibodies in human phase 1 trials (36,   37). However, most solid tumor cells are relatively   resistant to TRAIL-induced apoptosis. Even though,   numerous studies have shown that TRAIL resistance   can be overcome by the combined application of   chemotherapeutic drugs. Thus, finding natural phytoconstituents   able to enhance the apoptotic effect of   TRAIL, which is produced by cells of the immune   system as macrophages or natural killer cells (25), and   sensitizing TRAIL-resistant cancer cells represents   an important potential strategy for cancer therapy.</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> Pcy, similarly to phytochemicals such as curcumin   (38), quercetin (39, 40), apigenin (41), and   resveratrol (42) augments TRAIL-mediated apop   tosis in cancer cells by increasing the expression of   death-receptors on the cell surface, improvement   the transport of DR4/DR5 proteins into the cell   surface. The failure in trafficking mechanisms for   delivering TRAIL-death receptors may contribute   to TRAIL-resistance in colon cancer cells (43). In   SW480 cells, although the total amount of DR4 and   DR5 transcripts is similar in control and treated   cells, Pcy increase DR4 and DR5 expression at   cell surface and sensitize SW480 cells to TRAIL.   This effect was similar to the one observed by Jin     <i>et al</i>., 2004 (44) using the glycosilation inhibitor   tunicamicyn in SW480 TRAIL-resistant clones.   In contrast to TRAIL-resistant SW620 cells, Pcy   increased the levels of DR4/DR5 transcripts. This   event is correlated to the enhanced localization of   death receptors at the cell surface, which suggests   that Pcy regulate post-transcriptional mechanisms   involved in the delivery of death receptors to the   cell membrane in SW480 cells (45). On the other   hand, Pcy overcame TRAIL-resistance in SW620   cells by regulating the transcription and the intracellular   transport mechanisms, leading to increase   cell surface expression of TRAIL-death receptors.</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> It has been proposed that the basic expression   level on the cell surface is not enough to determine   TRAIL-sensitivity, but also the redistribution of   TRAIL-death receptors to the cell membrane and   the formation of lipid rafts, plasma membrane   microdomains enriched with cholesterol, glycosphingolipids   and caveolar-associated proteins,   such as caveolin. All of them are able to regulate   the efficacy of death receptor signaling throough   the redistribution in the cell membrane (42). In   colon cancer cells, resveratrol (46) and quercetin   (40) induced DR4/DR5 receptor redistribution in   lipid rafts colocalized with caveolin-1, becoming   sensitive to TRAIL, this lipid raft formation was   prevented by the cholesterol sequestering agent   nystatin. Caveolin-1 is an integral membrane protein   involved in cellular signaling transduction.   This protein has been described as a marker for   raft-associated caveolae which interacts with lipids   such as cholesterol, which are both structural   components of caveolae (47).</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> Pcy are able to activate the TRAIL-death receptor   pathway through a lipid-raft independent   mechanism in both cell lines. This is confirmed   with the analysis of lipid-raft fractions of Pcytreated   SW480 (45) and SW620 cells, where the   levels of DR4, DR5 and caveolin were similar to   the basal conditions. Caveolin protein can interact   directly and inhibits or sequester the inactive form   of many signaling molecules via the scaffolding   domain (47). Therefore, the direct activation of the   TRAIL-death receptor pathway by Pcy independent   of lipid raft-formation, could be considered an interesting   strategy for sensitizing SW480 and SW620   cells to TRAIL-death receptor mediated apoptosis,   and overcoming the resistance mechanisms that   suppress the signaling activity of TRAIL-death   receptors. It has been proposed that antitumor   properties of flavanols and Pcy can be associated to   the oligomeric chain length which directly influences   the interactions of the lipid bilayer and the   membrane proteins (48).</font></p>     ]]></body>
<body><![CDATA[<p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> In response to the interaction of Pcy with the cell   membrane, DR4 and DR5 are activated, the procaspase-   8 is recruited to the DISC complex via binding   to FADD (49) which results in caspase-8 activation.   This is supported by the ability of a selective inhibitor   of caspase-8 to reduce the induced apoptosis by   Pcy only, or Pcy combined with TRAIL in SW480   cells, compared to SW620 cells (26). Caspase-8 has   two important substrates, procaspase-3 and Bid   protein. Caspase-3 is the main downstream effector   caspase that cleaves the majority of the cellular   substrate in apoptotic cells (50). Bid is the link in   the crosstalk between the extrinsic and the intrinsic   apoptotic pathways. Bid also disrupts mitochondria   and favors the release of pro-apoptotic factors such   as cytochrome c (51). Caspase-8 cleaves Bid as efficiently   as it cleaves pro-caspase-3 (52). However,   although caspase-8 is activated in both cell lines   after Pcy and combined with TRAIL, Bid is cleaved   only in SW620-treated cells. As a consequence, a   decreased mitochondrial membrane potential is   observed in these cells, leading to the release of cytochrome   c into cytosol and to caspase-9 activation;   which indicates that the mitochondrial pathway   is activated in Pcy-induced apoptosis through the   action of TRAIL-death receptors.</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> The reason for an inefficient cleavage of Bid   protein in Pcy-treated SW480 cells is not the lack   of caspase-8 enzyme activity. It may be influenced   by posttranslational modifications of Bid (52),   mutations to Bid cleavage sites (53), or the presence   of a negative regulator (54) in SW480 cells. It   has been demonstrated that the phosphorylation of   Bid prevents caspase-8 cleavage (55). In addition,   truncated Bid form (tBid) has been reported to be   ubiquitinated and targeted for degradation (56). It   has also been shown that in the SW480 cells, the   overexpression of Bcl-2 blocked TRAIL-death   receptor mediated apoptosis by inhibiting Bax   translocation into mitochondria and reduced cytochrome   c release. Thus, strategies to overcome   the observed Bcl-2-mediated resistance to the mitochondrial   pathway have the potential to greatly   increase treatment efficacy. One possible approach   involves the use of small molecules inhibitor that   binds to Bcl-2 and inhibits it function (54).</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> Many studies have shown that cancer preventive   agents induced apoptosis through the generation of   ROS. Apoptosis induced by Pcy only or combined   with TRAIL in SW620 cells also involves generation   of ROS, which can result from the increased   polyamine catabolism, as well as from the mitochondrial   permeabilization caused by tBid and Bax   (26). ROS produced in cytosol may also activate a   cell intrinsic pathway of apoptosis by perturbing the   mitochondrial function which is inhibited by MDL   (18). Taken together, these observations suggest that   ROS generation is another mechanism by which   Pcy may sensitize TRAIL-resistant SW620 cells as   observed in cancer cells treated with resveratrol (46)   and curcumin (38). The accumulation of ROS leads   to mitochondrial functional changes, such as the   increased permeability transition pore opening and   loss of Dym, which are events associated with the   release of cytochrome c and caspase activation (27).</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> <b>Modulation of Fas- receptor mediated apoptosis</b></font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> Fas-receptor (CD95) is an integral cell membrane   protein and a member of the TNF receptor   family. Pcy sensitized SW480 cells to Fas receptormediated   apoptosis. This sensibilization was associated   with an up-regulated expression at the   post-transcriptional level of the Fas receptor without   significant changes at the transcriptional level,   which suggests that the sensitizing mechanism of   Pcy to Fas implies a favored delivery of the Fas   receptor to the cell membrane. On the contrary,   SW620 cells showed a Fas-resistant phenotype as it   was described above (57), despite the up-regulation   of Fas transcripts correlated with a huge expression   of the receptor at the cell surface.</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> Tumours have developed multiple mechanisms   for evading the surveillance of the immune system.   Most cancer cells are relatively resistant to   Fas-mediated apoptosis (58). This protects tumor   cells from FasL expressed as a cytotoxic mediator   by T cells (59) or NK cells (60) infiltrated into the   tumor. Colon cancer cells have acquired defensive   strategies (Fas resistance) against this effect by   either down-regulating Fas-receptor (61) or by   acquiring Fas-receptor signaling defects (58). A   mutated intracytoplasmic domain of Fas receptor   has been reported, precluding the establishment of   a functional DISC (62). Some cancer types express   high levels of Fas-associated phosphatase-1 (FAP-1)   (63) which interacts with the C-terminal region of   Fas, leading to the inhibition of downstream events.   The microinjection of a tripeptide, corresponding   to the three amino acids of Fas receptor C-terminal   region, prevented this interaction and restored the   Fas sensitivity of the colon cancer cell line (64).</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> The activation of Fas-receptor by apple Pcy was   confirmed in both cell lines through two strategies:     <i>i)</i> usising an antagonist antibody to Fas-receptor,   anti-Fas ZB4; <i>ii)</i> Pcy combination with an agonist   antibody of Fas-receptor, the anti-Fas CH-11 which   reproduces the activation by FasL. Under these conditions,   an increase in the number of hypodiploid   cells, a loss of mitochondrial membrane potential   and DNA fragmentation caused by the activation   of Fas receptor have been observed in SW480 cells.   The potentiated pro-apoptotic effects of anti-Fas   CH-11 were enhanced by Pcy which are abrogated   by the anti-Fas ZB4. We also observed in these cells   that Pcy combined with anti-Fas CH-11 activate a   type II (mitochondrial)-apoptotic pathway, which is   an effect also observed for anti-Fas CH-11 in other   experimental models (65). Whereas, the use of multimeric   forms of Fas ligand induces a physiologically   relevant apoptotic signaling type I (without mitochondria)   pathway through the activation of the Fas   receptor (66). In any case, these evidences supports   the concept that Pcy may help cancer cells to recover   Fas sensitivity, contributing to the elimination of   tumor cells by FasL or by agonists of Fas-receptor.</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> On the contrary, in SW620 cells the anti-Fas   CH-11 do not enhance the pro-apoptotic effects   observed with Pcy only. However, in SW620 cells   it is not excluded that the Fas-receptor might be   implicated in the Pcy-induced apoptosis after a   blockade of TRAIL-DR4/-DR5 receptors that   induce its activation by Pcy. This fact suggests that   Pcy are able to initiate a cross-talk between DR4/DR5 and Fas in metastatic cells. These findings   suggest molecular defects at the level of Fas signal   transduction. Thus, understanding the basis of   the resistance of metastatic-derived colon cancer   cells to Fas-mediated apoptosis might provide new      strategies and treatment types for targeting death   receptors in cancer cells (29).</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> In this study, we propose that Pcy may restore   Fas-sensitivity in metastatic cells by overcoming   several aspects, contributing to Fas-resistance:<i> i)</i>  the ratio between DR4/DR5 and Fas receptors   in cell membrane may play an important role in   determining Fas-sensitivity. The number of Fas   receptor relative to DR4/DR5 might not be sufficient   to induce Fas-mediated apoptosis, since both   types of receptors interact similarly with the adaptor   protein FADD (67, 68) after their activation by the   combined treatments Pcy /TRAIL or Pcy / anti-Fas   CH-11;<i> ii)</i> DR4/DR5 and Fas receptors have different   C-terminal tails. The corresponding region for   DR4 and DR5 positively regulates FADD binding,   caspase activation and apoptosis, whereas the Cterminal   tail of Fas receptor has the opposite effect   and inhibits the binding of FADD to the receptor   death domain (67). We may hypothesize that the   C-terminal tail of DR4 and DR5 receptors located   outside the death domain could present additional   regulatory sites for the activation of Fas receptor   in order to overcome an inactivation of DR4/DR5   receptors (67). However, currently there is no evidence   showing such a direct interaction between   Fas and DR4/DR5 receptors;<i> iii)</i> Cross linking of   FasL and TRAIL to their respective receptors activates   PKC which in turn triggers anti-apoptotic   mechanisms for the mitochondrial pathway (69).   Thus, one may speculate about the possibility that   the simultaneous inhibition with blocking antibodies   for DR4/DR5 and Fas affects PKC activity,   which can also be inhibited by apple Pcy in SW620   cells as described by Goss&eacute; <i>et al</i>., 2005 (8). However,   all these aspects deserve further investigations.</font></p>     <p>&nbsp;</p>     ]]></body>
<body><![CDATA[<p><font face="Verdana, Arial, Helvetica, sans-serif" size="3"> <b>CONCLUSIONS</b></font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> The different apoptotic signaling pathways   triggered by apple Pcy, demonstrated in the course   of this review, are summarized on <a href="img/revistas/vitae/v17n3/v17n3a12f2.jpg" target="_blank">figures 2</a> and   <a href="img/revistas/vitae/v17n3/v17n3a12f3.jpg" target="_blank">3</a>; where a differential induction of apoptosis between   SW480 and SW620 cells is illustrated. The   Pcy were able to induce apoptosis in SW480 cells   through the extrinsic apoptotic pathway involving   TRAIL-DR4/-DR5 and Fas receptors activated by   a post-transcription mechanism. On the contrary,   Pcy can induce apoptosis in SW620 cells through   the activation of the TRAIL-DR4/-DR5 or the   Fas apoptotic and intrinsic pathway, involving a   crosstalk between these two pathways by the tBid   protein. These death receptors may be up-regulated   by a transcriptional mechanism yet unknown.   Moreover, Pcy-induced apoptosis in SW620 cells involved   ROS production from increased polyamine   catabolism, leading to mitochondrial disruption.</font></p>     <p>&nbsp;</p>      <p><font face="Verdana, Arial, Helvetica, sans-serif" size="3">     <b>REFERENCES</b></font></p>     <!-- ref --><p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> 1. Gerh&auml;user C. Cancer, Chemopreventive Potential of Apples,   Apple Juice, and Apple Components. Planta Med. 2008 Oct; 74   (13): 1608-1624.</font>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;[&#160;<a href="javascript:void(0);" onclick="javascript: window.open('/scielo.php?script=sci_nlinks&ref=000067&pid=S0121-4004201000030001200001&lng=','','width=640,height=500,resizable=yes,scrollbars=1,menubar=yes,');">Links</a>&#160;]<!-- end-ref --><!-- ref --><p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"> 2. 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